Citation Nr: 21070565 Decision Date: 11/24/21 Archive Date: 11/24/21 DOCKET NO. 18-02 286 DATE: November 24, 2021 ORDER New and material evidence having been received, the Veteran's claim for service connection for an acquired psychiatric disorder is reopened. Entitlement to service connection for an acquired psychiatric disorder is granted. FINDINGS OF FACT 1. Entitlement to service connection for posttraumatic stress disorder (PTSD), also claimed as depression, anxiety, stress, and sleep disorder, was denied in a September 2012 rating decision; new and material evidence has been received since the September 2012 rating decision. 2. Resolving reasonable doubt in the Veteran's favor, he is found to have an acquired psychiatric disorder which as likely as not is related to stressors in service. CONCLUSIONS OF LAW 1. As the evidence received subsequent to the September 2012 rating decision is new and material, the requirements to reopen the claim of entitlement to service connection for an acquired psychiatric disorder are met. 38 U.S.C. §§ 5108, 7105; 38 C.F.R. §§ 3.102, 3.156. 2. The criteria for entitlement to service connection for an acquired psychiatric disorder have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1974 to November 1979, and June 2004 to January 2005, with additional service in the Air National Guard. This case comes to the Board of Veterans' Appeals from an April 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office. The Board notes that although the Regional Office has primarily characterized this issue as a claim for service connection for PTSD, the Veteran's claim was for PTSD, anxiety, and sleep disturbance, and his VA treatment records show that he has received a variety of different diagnoses regarding the same reported symptomatology, including major depressive disorder, PTSD, adjustment disorder, and other specified trauma and stressor related disorder. Because the Board is not in a position to determine which of these diagnoses, all provided by competent medical professionals, is the "correct" diagnosis, and to afford the greatest benefit to the Veteran, the Board has recharacterized this issue to be entitlement to service connection for an acquired psychiatric disorder. See, e.g., Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). The Veteran initially submitted a claim for service connection for PTSD, depression, anxiety, stress, and sleep disorder in September 2010. This claim was denied in a September 2012 rating decision. The Veteran submitted a notice of disagreement with this decision, and a Statement of the Case was issued in October 2012. The Veteran did not perfect an appeal of this issue by submitting a Form 9 substantive appeal, and the September 2012 rating decision is therefore final. See 38 U.S.C. § 7105; 38 C.F.R. §§ 20.204, 20.302, 20.1103 (2012). A previously denied claim may be reopened by the submission of new and material evidence. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. For purposes of determining whether new and material evidence has been received to reopen a finally adjudicated claim, the evidence will be presumed credible. See Kutscherousky v. West, 12 Vet. App. 369, 371 (1999). Since the last final decision in September 2012, the record contains many additional VA treatment records which indicate that he has received several new psychiatric diagnoses, including adjustment disorder and other specified trauma and stressor related disorder. In June 2017, a VA clinical psychologist found that the Veteran had other specified trauma and stressor related disorder due to stressful experiences the Veteran had in service. The Board therefore finds that there is new and material evidence which relates to unestablished elements needed to substantiate the claim, and the issue is reopened. See 38 U.S.C. § 5108; 38 C.F.R. § 3.156(a). The Board also finds that affording the Veteran the benefit of the doubt, there is sufficient evidence to grant the claim. Generally, to establish service connection for PTSD, the evidence must show: (1) a current diagnosis of PTSD; (2) credible supporting evidence that the claimed in-service stressor occurred; and (3) a causal relationship between the present disability and the in-service stressor. 38 C.F.R. § 3.304(f)(1), 4.125(a). For other psychiatric disorders, service connection will be granted if the evidence demonstrates that the disorder resulted from an injury or disease incurred in or aggravated by active military service. 38 C.F.R. § 3.303(a). While the Regional Office was unable to verify any specific stressor incident in service, the Veteran has argued that the stress and trauma from being around dead bodies being transported through Germany caused the start of his psychiatric symptoms. The Veteran's DD Form 214 shows that his primary specialty was air transportation superintendent, and it is plausible that he would be involved with the process of bodies being transported. Furthermore, the Veteran has several additional psychiatric diagnoses other than PTSD, including other specified trauma and stressor related disorder, and actual verification of the stressor event is not required to establish service connection for disorders other than PTSD if the preponderance of the evidence indicates that they began in service. There is also probative medical evidence which relates the Veteran's military experiences to his current psychiatric diagnoses. The Veteran attended a VA examination in September 2011. The Veteran reported that his symptoms began in 2004, when he was dealing with body bags from the Iraq War, and that he began having symptoms of anxiety and sadness. He also reported that one young airman would not work around the dead bodies, and this airman physically threatened him. He reported that he continues that have distance from his wife, trouble sleeping, nightmares, violent behavior. The examiner found that the Veteran's symptoms did meet the criteria for a diagnosis of PTSD, and he discussed how each required element was met. He wrote that the Veteran was exposed to events that involved death, even though his life was not threatened, and explained that he did feel intense fear, helplessness, and horror, and that this did constitute a valid stressor event for PTSD. The examiner wrote that the Veteran's depression, anxiety, and sleep problems were also related to the PTSD, since these problems started when he was in service, while working with the body bags. The Veteran's VA treatment records also show that the Veteran has received several other psychiatric diagnoses, and while he has reported having other non-military stressors and triggers for these symptoms, he has also consistently reported that his symptoms began while he was in the military and stationed in Germany. The Veteran had a virtual psychotherapy consultation in June 2017 with a VA psychologist, where he discussed having nightmares, problems sleeping, and being moody and angry. He discussed how he had been a superintendent overseeing the transportation of body bags in service, and that he had to have one airman removed from duty because he could not handle the assignment. He stated that his nightmares began soon after he returned home from Germany. The examiner found that the Veteran's reported stressor was not sufficient to satisfy the DSM-5 criterion of a traumatic stressor. She did, however, find that the Veteran had intrusive memories about handling the body bags, as well as avoidance, negative cognition, and arousal/reactivity, which were related to problems in service. Although the psychologist did not find that the Veteran met the criteria for a diagnosis of PTSD, she did diagnose him with other specified trauma and stressor related disorder. These evaluations were provided by competent psychologists, and their findings are consistent with the other evidence of record. While the two psychologists came to differing conclusions about whether the Veteran met the criteria for PTSD, their findings are not substantially different, and both show that the Veteran has symptoms of anxiety, nightmares, depression, and anger which began during or immediately after the Veteran's military service, and which have been related to stressful experiences in service. The evaluations constitute highly probative medical evidence, as they were based on in-person interviews of the Veteran and an accurate understanding of the Veteran's medical history, and they are supported by adequate rationale to support their findings. See Prejean v. West, 13 Vet. App. 444, 448-9 (2000). The Board therefore finds that there is adequate probative medical evidence which relates the Veteran's current psychiatric diagnoses to his military service. There are no other conflicting medical opinions which state that his psychiatric symptoms are not related to service. The Board therefore finds that there is adequate, probative medical evidence indicates that the Veteran has current psychiatric diagnoses which have been related to stressful experiences during his military service. Entitlement to service connection for an acquired psychiatric disorder is therefore granted. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Mary E. Rude, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.